NY Hospital Quality: Budget cut endangers independent report card

David Lassman/The Post-Standard DANAE TALLINI, a registered nurse at Upstate University Hospital at Community General, demonstrates handwashing at a sink in a patient room. In a new report card, the hospital was recognized for having a lower-than-average rate of bloodstream infections after surgery.

For nine years, a small nonprofit research outfit in the Buffalo area has been compiling a report card on the performance of New York hospitals.

Thanks to the Niagara Health Quality Coalition’s work over those nine years, health care consumers learned that Central New York hospitals were doing a good job of slowing the revolving door of patient readmissions; that local patients were being accidentally cut or punctured during medical procedures at rates exceeding state and national averages; that death rates were dropping but infection rates were rising at hospitals across the state; and a million other statistics available for searching and comparing at www.MyHealthFinder.com.

A penny-wise but pound-foolish budget decision has put this work at risk. The coalition did not receive $250,000 in state funding this year, an amount that makes up about half of its annual budget. A delay in receiving its funding from last year’s budget bit into the nonprofit’s reserves, so there’s little left to cushion the blow.

No doubt, the state is in a fiscal bind. Gov. Andrew Cuomo and the New York state Legislature faced a $10 billion deficit this year, and difficult decisions had to be made.

But as coalition president and CEO Bruce Boissonnault pointed out, the state is the largest single purchaser of health care in New York. It serves the state’s interests, as well as consumers’, to preserve an independent source of information about the quality of health care dispensed around the state. The New York State Hospital Report Card is just such a source.

The most recent report card, released Sunday, showed Upstate University Hospital and Oswego Hospital had below-average results on some quality measures, landing them on a “watch list” of 20 hospitals statewide.

The hospitals were quick to dispute the group’s findings, taking issue with the age of the data (from 2009), the methodology used to adjust for the hospitals that take the riskiest cases, and the use of billing data instead of clinical records to draw conclusions about patient care.

Interpreting the data can be tricky. As British statesman Benjamin Disraeli observed, there are lies, damn lies and statistics. But it’s hard to see how having less information available about hospital performance will be good for anybody — especially the hospitals themselves.

In fact, the hospital report card’s main purpose is to pressure hospitals into improving. And they have. Since the Niagara Health Quality Coalition’s first report in 2002, statewide hospital mortality rates have decreased by more than 50 percent, error rates have declined and other indicators of hospital quality and safety have improved. The report card may not be the only reason for the improvement, but it certainly is one big one.

If the New York Hospital Report Card goes away, who will provide this very public incentive for hospitals to improve? You can bet it won’t be the health care industry, which kept this information to itself before the Niagara Health Quality Coalition started publishing it.

No report card is perfect — just ask your kids — but this one serves a vital role in pointing out where hospitals can do better. It must be preserved.